Acute Necrotizing Ulcerative Gingitivitis (ANUG) is a distinct and specific disease. This disease entity has been described as far back as the days of Hippocrates and is known by many synonyms. With the advent of antibiotics and with improved nutritional status, the incidence has decreased and even become extinct in developed countries. However, with the increasing incidence of severe immunodeficiency states such as seen in Acquired Immunodeficiency Syndrome (AIDS) the lesion has once more, become a well recognized and often encountered clinical entity in developed countries. In developing countries, however, the condition is still a commonly diagnosed clinical lesion because of the persistently poor nutritional status. Because of the current campaign for increased focus on global health issues, ANUG, a lesion of significant interest for the developing countries where malnutrition is high and for developing countries because of the AIDS, a global pandemic has resurfaced as a topic for discussions and study. This literature review will provide a better understanding of the epidemiology, etiology, and pathophysiology of ANUG associated with malnutrition.